Psychologic changes in orthognathic surgery patients: a 24-month follow up.

This report describes the final, two-year follow up in a longitudinal study of 74 patients who underwent orthognathic surgery for developmental deformities. Data for all six measurement periods were available for 46 patients. Complaints of functional problems decreased significantly from before surgery to 24 months after, although 49% of the patients continued to report lip paresthesia. The incidence of postsurgical problems had no effect on the satisfaction expressed with surgical outcomes, which remained high throughout the postoperative course. Self-esteem appeared to rise in anticipation of surgery, only to decline significantly at nine months after surgery, to rise again by 24 months (but not as high as before surgery). In some components, self-esteem remained significantly lower after surgery than before. Body image also showed a decline at nine months, although overall body image and profile image 20-26 months after surgery were significantly more positive than before surgery. These results point to the importance of continued contact with orthognathic surgery patients by surgeons and orthodontists for at least two years after surgery, particular attention being paid to the intermediate stages (six to 12 months) after surgery. This period of psychologic upheaval appears to be related to the patient's desire to complete postsurgical orthodontics.